As Veterans age, confronting illness and role changes, they may experience later adulthood trauma reengagement (LATR). To better understand this process in medically ill Veterans, we completed six focus groups with 21 VA Home Based Primary Care (HBPC) mental health clinicians in rural and urban settings; 14 completed a follow-up survey. Thematic analysis of focus groups confirmed the LATR model with unique presentation and treatment challenges related to medical, physical, and cognitive changes. In surveys, the most challenging symptoms were: intrusive symptoms, dissociative reactions, and psychological/physiological reactivity (79%). In addition to focus group themes, surveys described challenges related limited social engagement, Veteran ambivalence, and lack of empirically supported treatments appropriate to HBPC. Results of these focus group and survey data provide key insights into the unique presentation of trauma in aging medically ill Veterans. Ongoing efforts to adapt materials and resources for this population will be described.
There is a longstanding shortage of teaching faculty and clinicians trained in psychology and aging (Moye et al. 2019). Further, there are few marginalized group members in the geriatric workforce. To better understand this issue, a survey was distributed to psychology and aging listservs in preparation for the “Building Bridges” conference. Problems noted by respondents (N=275) included fewer applicants for aging-related positions (42%), decreased interest in aging by students (32%), loss of aging-related positions (18%); 24% thought workforce problems are worse than 5 years ago. Similar themes emerged in qualitative comments including: (1) lack of applicants/ interest, (2) lack of or decline in the training/ education opportunities, (3) lack of finances/ funding/ resources, (4) lack of professional positions, and (5) positive experiences/ actions/ change. Themes specific to marginalized group members to support diversity, equity, and inclusion include mindful commitment, education (e.g., mentorship), and recognizing not doing enough.
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